Prevention of drowning.

ABSTRACT Drowning is a leading cause of injury-related death in children. In 2006, approximately 1100 US children younger than 20 years died from drowning. A number of strategies are available to prevent these tragedies. As educators and advocates, pediatricians can play an important role in the prevention of drowning.

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Drowning is the leading cause of death from unintended injury in children globally. Drowning is preventable, and mechanisms exist which can reduce its impact, however the peer-reviewed literature to guide public health interventions is lacking. This paper describes a protocol for a review of drowning prevention interventions for children. Electronic searching will identify relevant peer-reviewed literature describing interventions to prevent child drowning worldwide. Outcome measures will include: drowning rates, water safety behaviour change, knowledge and/or attitude
change, water safety policy and legislation, changes to environment and water safety skills. Quality appraisal and data extraction will be independently completed by two researchers using standardised forms recording descriptive and outcome data for each included article. Data analysis and presentation of results will occur after data have been extracted. This review will map the types of interventions being implemented to prevent drowning amongst children and identify gaps within the literature.

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Objectives
To determine the frequency of accidental drowning seen in paediatric emergency departments, to define the epidemiological profile of the victims, and to analyse the circumstances related to prognosis and survival.Patients and methodsA multicentre, prospective and descriptive study was conducted on victims of accidental drowning seen in 21 paediatric emergency departments between June and September 2009 and 2010. We collected personal, environmental, safety, security data, as well as the need for cardiopulmonary resuscitation (CPR), hospitalisation rate, sequelae and mortality.ResultsOut of 234,566 emergency department cases, 53 were due to accidental drowning (frequency: 2.2/10,000 consultations during the summer period, 64.2% males). The median age was 3.5 years (p25-75: 2.6-8.4), with 34 had less than 6 years. Thirty-two children were hospitalised. Most drowning occurred in the afternoon (40), in freshwater (49), in private pools (33) and unprotected (33). The victims, mostly healthy children (40), did not know how to swim (38) and were not wearing flotation systems (37/38). There was lack of supervision in 42 cases. Acidosis (20) and hypoxaemia (18) were the most frequent findings. Five children died, 4 were healthy, none knew how to swim or had a float device, and none were supervised. Thirty six children required CPR, mostly applied by family (15). In the children who died, CPR was started after 3 min. Two survivors had hemiparesis.Conclusions
Accidental drowning was a rare cause of consultation in paediatric emergency departments. In children less than 6 years, who did not know how to swim, did not use flotation devices in unprotected private pools, and were not properly supervised, there is an increased of suffering from accidental drowning and its associated morbidity. An immersion time> 10 min, starting CPR > 3 min, acidosis, hyponatraemia, and hypothermia on arrival at the emergency department increases mortality. Training family members in cardiopulmonary resuscitation can be useful.

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Objective: The aim of this longitudinal study was to determine how children's participation in swim lessons impacts parents' appraisals of children's drowning risk and need for supervision. Method: Parents with 2-5-year old children enrolled in community swim lessons completed the same survey measures up to 4 times over an 8-month period. Results: Multilevel regression analyses examining temporal relationships between parents' perceptions of their child's swim ability, supervision needs around water, and children's ability to keep themselves safe in drowning risk situations revealed that as children progressed through swim lessons, parents' perceptions of their child's swim ability and their belief that children are capable of keeping themselves safe around water increased. Further, the relation between parents' perceptions of swim ability and judgments of children's supervision needs was mediated through parents' judgment about their child's ability to secure their own safety near water. Conclusions: As parents perceive their child to be accumulating swim skills, they increasingly believe that children are capable of keeping themselves from drowning, and as a result, that less active parent supervision of their child is necessary. Implications of these findings for intervention efforts to counter this unwelcome way of thinking that may arise through continued participation in swim lessons are discussed. Incorporating a parent-focused component into children's learn-to-swim programs to promote more realistic appraisals of children's supervision needs and drowning risks may further enhance the positive benefits that swim lessons have for children's safety. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

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